Itraconazole versus fluconazole a double-blind comparison in tinea corporis

Itraconazole and fluconazole are azole derivatives widely used in the treatment of dermatophyte infections. The aim of the present clinical investigation was to compare the efficacy and safety of these antifungal drugs in the treatment of tinea corporis. In this multicenter, double-blind, comparative study, 38 patients with mycologically confirmed tinea corporis were randomized to receive treatment with itraconazole (100mg/day) or fluconazole (50 mg/day) for 15 days. Thirty-seven of the patients were evaluable at the end of the trial. Both drugs resulted in a marked improvement in, or elimination of, all clinical symptoms; however, the mean score for inflammation and desquamation was consistently lower in the itraconazole group. The number of patients with positive mycological findings was also reduced, so that at the end of the 2-week treatment, 72.2% of patients receiving itraconazole and 47.4% of those treated with fluconazole had negative results. However, the overall assessment at the end of the 10- week follow-up did not show significant differences between the groups, with 94.4% (itraconazole) to 84.2% (fluconazole) of patients being clinically and mycologically cured. Mild adverse events were reported by 3 patients treated with fluconazole and one subject receiving itraconazole. Although itraconazole appears to be associated with a faster clinical response and higher frequency of mycological clearance, the results suggest that itraconazole is as effective as fluconazole in the treatment of tinea corporis.